床旁超声预测慢性乙型肝炎患者胃镜检查围麻醉期误吸风险的临床价值(1)
摘要：目的 研究床旁超聲检查仰卧位下胃窦评估围麻醉期慢性乙型肝炎患者误吸风险的临床价值。方法 选择我院接受常规胃镜检查的慢性乙型肝炎患者200例，依据胃镜所见胃内容物性质将患者分为固体组与液体组，利用四个表判断床旁超声定性分组可靠性;按照收集胃液量，将胃镜判定液体组患者分为空腹组(≤0.8 ml/kg)与非空腹组(>0.8 ml/kg)，比较胃窦横截面积(CSA)组间差异。结果 200例患者中，胃镜分组固体组17例(床旁超声分组固体组7例，非固体组10例)，液体组183例(床旁超声分组固体组2例，非固体组181例)，床旁超声诊断胃内含有固体内容物的阳性预测值与阴性预测值分别为77.78%和94.76%，诊断符合率94.00%。胃镜液体组中含空腹组160组和非空腹组23例，床旁超声测量胃窦CSA组间差异显著[(4.83±1.04)cm2 vs (5.90±1.60)cm2，P<0.01]。结论 床旁超声检查仰卧位下胃窦可准确判断慢性乙型肝炎患者胃内容物情况，指导临床麻醉医生评估围麻醉期误吸风险。
关键词：床旁超声;慢性乙型肝炎;麻醉;误吸
, 百拇医药
中图分类号：R614 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.08.035
文章编号：1006-1959(2019)08-0123-03
Abstract：Objective To evaluate the clinical value of bedside ultrasonography in evaluating the risk of aspiration in patients with chronic hepatitis B during peri-anaesthesia. Methods A total of 200 patients with chronic hepatitis B who underwent conventional gastroscopy were selected. The patients were divided into solid group and liquid group according to the nature of gastric contents seen by gastroscope. Four tables were used to judge the reliability of bedside ultrasound qualitative grouping. The amount of gastric juice was divided into two groups： the fasting group (≤0.8 ml/kg) and the non-fasting group (>0.8 ml/kg). The difference in gastric sinus cross-sectional area (CSA) was compared. Results Of the 200 patients， 17 were in the gastroscopy group (7 in the bedside ultrasound group， 10 in the non-solid group)，183 in the fluid group (2 in the bedside ultrasound group， 181 in the nonsolid group). The positive predictive value and negative predictive value of bedside ultrasound diagnosis of solid contents in the stomach were 77.78% and 94.76%， respectively， and the diagnostic coincidence rate was 94.00%. In the gastroscope group， there were 160 patients in the fasting group and 23 patients in the non-fasting group. The difference between the bedside ultrasound and the gastric sinus CSA group was significant [(4.83±1.04) cm2 vs (5.90±1.60) cm2，P<0.01]. Conclusion Bedside ultrasound examination of the lower antrum of the supine position can accurately determine the gastric contents of patients with chronic hepatitis B， and guide the clinical anesthesiologist to assess the risk of aspiration during the anesthesia period., 百拇医药(傅蕊 李士欣 周国强 李依泽)
关键词：床旁超声;慢性乙型肝炎;麻醉;误吸
, 百拇医药
中图分类号：R614 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.08.035
文章编号：1006-1959(2019)08-0123-03
Abstract：Objective To evaluate the clinical value of bedside ultrasonography in evaluating the risk of aspiration in patients with chronic hepatitis B during peri-anaesthesia. Methods A total of 200 patients with chronic hepatitis B who underwent conventional gastroscopy were selected. The patients were divided into solid group and liquid group according to the nature of gastric contents seen by gastroscope. Four tables were used to judge the reliability of bedside ultrasound qualitative grouping. The amount of gastric juice was divided into two groups： the fasting group (≤0.8 ml/kg) and the non-fasting group (>0.8 ml/kg). The difference in gastric sinus cross-sectional area (CSA) was compared. Results Of the 200 patients， 17 were in the gastroscopy group (7 in the bedside ultrasound group， 10 in the non-solid group)，183 in the fluid group (2 in the bedside ultrasound group， 181 in the nonsolid group). The positive predictive value and negative predictive value of bedside ultrasound diagnosis of solid contents in the stomach were 77.78% and 94.76%， respectively， and the diagnostic coincidence rate was 94.00%. In the gastroscope group， there were 160 patients in the fasting group and 23 patients in the non-fasting group. The difference between the bedside ultrasound and the gastric sinus CSA group was significant [(4.83±1.04) cm2 vs (5.90±1.60) cm2，P<0.01]. Conclusion Bedside ultrasound examination of the lower antrum of the supine position can accurately determine the gastric contents of patients with chronic hepatitis B， and guide the clinical anesthesiologist to assess the risk of aspiration during the anesthesia period., 百拇医药(傅蕊 李士欣 周国强 李依泽)